The Link between Tampons and Toxic Shock Syndrome

Can wearing tampons lead to toxic shock syndrome? Alanna O’Shea investigates.There are many terrifying things about puberty. Your hormones are raging, your body is becoming unfamiliar and absolutely everything is embarrassing. Even worse, if you are a girl you have to deal with things like tampons and pads for the very first time. Tampons themselves are frightening little things; but then you hear the phrase “toxic shock syndrome” for the first time. As you are handed your first box of tampons by your mum you might be warned “not to leave them in too long or else you’ll get toxic shock syndrome (TSS).” You might hear about TSS from the more worldly girls at school or chat nervously with your friends about it at a sleepover. What exactly TSS was, no one was able to tell you: you just knew it was bad. You had just gotten over being scared of the monster underneath your bed and now, here was an even more terrifying, menstrual bogeyman.
“The model Lauren Wasser almost lost her life to TSS (caused by a tampon) and had to have her right leg amputated.”
I’m sorry to tell you that TSS is a very real, but rare, syndrome. A tampon, absorbent and filled with nutrient rich blood, provides an ideal place for bacteria to set up shop. Menstrual TSS is caused when a bacteria called Staphylococcus aureus colonise a tampon. Once it has colonised the tampon, the bacteria releases something called a superantigen which is then absorbed by your body. The superantigen provokes a massive immune response by activating certain cells in your immune system and by releasing large amounts of inflammatory mediators. This is when the trouble starts.Many people will experience two to three days of mild, flu-like symptoms before they develop TSS. The disease can progress rapidly and symptoms include a sudden high fever, vomiting and diarrhea, and a rash that looks like sun-burn. It can also cause a decrease in blood pressure which can then progress to shock – a dangerous state where your organs are not receiving a sufficient blood supply.If you are feeling these symptoms while you are wearing a tampon during your period, remove your tampon immediately and seek medical attention. Most importantly if you feel like you have the serious symptoms of TSS, tell your doctor if you are or were wearing a tampon. TSS syndrome can be a serious, fatal disease but it can be cured by antibiotics.It is important to note, in among all this scary stuff, that this is a very rare disorder. It probably affects around 1 in 10,000 women who use tampons. There was a time when mentrual TSS was more common – this is probably why your mum may have frightened the living daylights out of you about it when you were 13.The first documented cases of menstrual TSS occurred just over 30 years ago and were associated with the rise of new, super absorbent tampons. The modern tampon had been around since 1929, but before the 1980s, tampons had always been made out of cotton. Now, new tampons made of synthetic materials were flooding the market, perfumed and promising to absorb 20 times their weight in fluid. One tampon was marketed to be worn for over 24 hours. There was a huge influx of women into emergency rooms with the symptoms of TSS. Once people realised that super absorbent tampons were the culprit, these items were removed from the shelves. The rate of TSS caused by tampons severely decreased but the disease has never gone away. Menstrual TSS now only accounts for 50 per cent of the cases, with many occurring after surgery, and even simple skin infections can cause TSS.   Every so often a news item of a woman with TSS may appear online or on your Facebook news feed and strike fear in the hearts of the menstruating. A few years ago, the model Lauren Wasser almost lost her life to TSS (caused by a tampon) and had to have her right leg amputated. Her story went viral this year after she walked in this year’s New York Fashion week with her prosthetic leg proudly on show. There are a few easy things that you can do to reduce your risk of getting TSS. Wash your hands when removing and inserting a tampon. Most importantly, change your tampon every 4-8 hours. Consider wearing a pad instead of a tampon one day of your period. If you have had TSS before, your doctor will most likely tell you not to wear tampons.Hopefully, if we continue to educate women on the causes and symptoms of TSS we can make the syndrome almost a thing of the past, leaving the pubescent girls of the future one less thing to worry about.